ENCEPHALITIS is the non suppurative inflammation of brain.
Various viruses may cause encephalitis. They are listed below. Japanese B encephalitis virus (common in our country) Enterovirus.
Herpes simplex and zoster varicella virus.
The west Nile virus and other Arboviruses
Benign lymphocytic choriomeningitis virus.
Post infectious encephalitis (Hypersensitivity).
Onset: Usually acute but may be gradual.
There may be fever (moderate degree), headache, aches and pains all over the body, myalgia, arthralgia, anorexia, nausea, vomiting, lethargy, gradually there may be stupor or coma. There may be recurrent convulsive seizure. Involuntary movements are present.
Features vary according to the involved virus.
When meninges are involved there may be meningo- encephalitis, and neck stiffness may be present. When spinal cord is also affected in addition i.e. there is encephalomyelits, there will be hemiplegia, quadriplegia and bladder involvement. Plantar reflex is extensor in type, jerks are bisk.
Blood count is variable, CSF shows slight increase in pressure, protein is raised, sugar is normal, cells show lymphocytic pleocytosis.
CT scan is usually normal.
In serial examination increasing titres of antibody to the causative viruses may be seen.
For viral antigen PCR should be down.
EEG and MRI may also be helpful.
Encephalites should be differentiated from meningitis, Poliomyelitis, metabolic encephalopathis and stroke syndrome. Apart from this the exact causative virus should be searched as far as practicable.
Progress: Very much variable.
General measures for unconscious patients should be undertaken. These cases are better managed in ITU. Anticonvulsant drugs for convulsion, steroids (Dexa methasone 4-6 mgm 6-8 hourly, support to nutrition should be through Ryle’s tube. Catheter should be used for urine retention. Specific drugs may be given if the underlying agent can be identified. But as it is very difficult Acyclovir inj. 10 mgm/kg 8 hourly IV may be given.
TYPES OF SPECIFIC PNEUMONIA Staphylococcal Pneumonia TYPES OF SPECIFIC PNEUMONIA It may be a primary respiratory infection or secondary to…
ACUTE LOBAR PNEUMONIA It is the commonest of all specific pneumonias. AETIOLOGY Predisposing causes Age: All ages but 50% of…
BRONCHIAL ASTHMA DEFINITION OF BRONCHIAL ASTHMA BRONCHIAL ASTHMA is a chronic reversible inflammatory destructive disease of the airways characterised by…
BRONCHIECTASIS DEFINITION BRONCHIECTASIS is a condition of permanent abnormal dilatation of the larger bronchi. AETIOLOGY AND PATHOGENESIS Acquire Obstruction Obstruction…
CHRONIC BRONCHITIS DEFINITION OF CHRONIC BRONCHITIS Chronic bronchitis may be defined as a disease characterised by cough and sputum for…
ACUTE TRACHEO BRONCHITIS DEFINITION ACUTE TRACHEO BRONCHITIS is Acute inflammation of Tracheo bronchial tree caused by various organisms (bacteria and…